In an industry as complex and intricate as healthcare, efficiency isn’t just a luxury—it’s a necessity. For medical and behavioral health practices, one of the critical areas that demand keen attention is coding and billing. A well-oiled billing system not only ensures seamless operations but also helps you reach your full revenue potential. Here are some best practices to help your practice excel.
Keep Your Clean Claim Rate Above 95%
A ‘clean claim’ is one that has no errors, omissions, or inconsistencies that would cause an insurance company to either deny or delay payment. Strive to maintain a clean claim rate above 95% to minimize time-consuming and costly rework. Training staff in efficient coding and billing procedures can help you achieve this goal.
Don’t Skip Analyzing Your Payer Reimbursements
Routine evaluation of your payer reimbursements can offer valuable insights into your revenue cycle. Regularly examining these reimbursements allows you to spot trends, discover inconsistencies, and identify any underpayments or errors. An analytical approach to billing can make a significant impact on your bottom line.
Get a Grip on Your Accounts Receivable
In medical billing, accounts receivable (A/R) is the balance of money due for rendered services. A high A/R is often indicative of inefficiencies in your billing system, including delayed payments and claim denials. To improve, conduct periodic reviews to flag old balances and put in place strategies to facilitate quicker payments.
Get Back to the Basics of Revenue Cycle Management
Periodically revisiting the fundamentals of revenue cycle management can reveal opportunities for improvement. As best practices evolve, staying rooted in the basics allows for more agile and responsive adjustments to your billing system. Routine audits can reveal both strengths and weaknesses, guiding you towards areas for refinement.
Properly Submit Accurate Claims
Submitting clean, accurate claims with complete information is non-negotiable. Mistakes can lead to claim denials, which not only delay payment but also drain valuable administrative resources to correct the errors. Double-checking the information on the claims and using advanced billing software can mitigate these issues.
Stay Up to Date on Medical Billing Rules and Regulations
Medical billing is governed by a host of federal, state, and payer-specific regulations. Failure to stay current can result in non-compliance, claim denials, and in extreme cases, legal repercussions. Regular training sessions and updates can help keep your team informed and compliant.
Always Look for Areas to Improve
The landscape of medical billing and coding is ever-changing. Continual evaluation of your billing processes can help identify inefficiencies, bottlenecks, or even new best practices that can be incorporated into your workflow. Be proactive rather than reactive, and you’ll stay ahead of the curve.
How OHCS Can Elevate Your Billing and Coding Practices
It’s one thing to understand the importance of efficient billing and coding—it’s another to implement best practices effectively. That’s where OHCS comes into play. With our depth of experience in both medical and behavioral health sectors, we offer specialized services ranging from account review and analysis to consulting aimed at maximizing your funds. Our experts stay up-to-date with the latest regulations, ensuring that your practice remains compliant while optimizing revenue. Whether you need to refine your revenue cycle management or streamline your accounts receivable, OHCS is the partner you can rely on to help you achieve billing and coding excellence.
Conclusion
Billing and coding are more than just administrative tasks; they’re the backbone of your practice’s revenue generation. Implementing these best practices in your medical and behavioral health practice can result in more efficient operations and increased revenue, offering better care for your patients and a more streamlined workflow for your staff.
